Kathleen A Donahue, PSYD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

012973-1 Issued in NY

Practice address

31 Brockway PL
Brockport, NY 14420-2207

Phone

(585) 319-1546

Fax

(585) 395-1887

NPI assigned

Dec 4, 2006

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 7

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Annette M. Hertzlin-Lockamyeir, LCSW PLLC

  • Clinical Social Worker
  • Albion, NY
  • NPI 1538241732
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1165190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1982762886",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31 BROCKWAY PL",
            "city": "BROCKPORT",
            "state": "NY",
            "postal_code": "144202207",
            "telephone_number": "585-319-1546",
            "fax_number": "585-395-1887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31 BROCKWAY PL",
            "city": "BROCKPORT",
            "state": "NY",
            "postal_code": "144202207",
            "telephone_number": "585-319-1546",
            "fax_number": "585-395-1887"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DONAHUE",
        "first_name": "KATHLEEN",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "012973-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7059494",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED CARE",
            "identifier": "179887FC",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDEPENDENT HEALTH",
            "identifier": "6111459",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIDELIS",
            "identifier": "0002627690",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNIVERA",
            "identifier": "00026276901",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01777173",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF WESTERN NY",
            "identifier": "000525385001",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kristy Genung Dibelka, LMT
• Sarah B Dick, LPN
• Alyssa A Dimartino
• Doctor Hany G Nissiem Family Medicine PLLC
• Barbara A Dodson, LPN
• Marissa Lee Douglas, LMHC
• Karissa Anne Dube, PHARMD
• Briana Dunton
• Joshua Adam Dvorak, DMD
• Jennifer Dys, RPH

• Clinical Psychologist in Brockport, NY
• Providers in Brockport, NY by specialty
• Clinical Psychologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.